Topic:Cardiovascular Health
Cardiovascular health in horses encompasses the study of the heart and blood vessels, focusing on their structure, function, and associated disorders. The equine cardiovascular system is responsible for the circulation of blood, delivering oxygen and nutrients to tissues, and removing waste products. Research in this area includes the examination of cardiac anatomy, the electrophysiology of the heart, and common cardiovascular conditions such as arrhythmias, valvular diseases, and heart murmurs. Diagnostic tools such as echocardiography, electrocardiography, and cardiac biomarkers are utilized to assess cardiovascular function and detect abnormalities. This page compiles peer-reviewed research studies and scholarly articles that explore the physiological mechanisms, diagnostic approaches, and therapeutic strategies related to cardiovascular health in horses.
Effects of vatinoxan on cardiorespiratory function, fecal output and plasma drug concentrations in horses anesthetized with isoflurane and infusion of medetomidine. A constant rate infusion (CRI) of medetomidine is used to balance equine inhalation anesthesia, but its cardiovascular side effects are a concern. This experimental crossover study aimed to evaluate the effects of vatinoxan (a peripheral α2-adrenoceptor antagonist) on cardiorespiratory and gastrointestinal function in anesthetized healthy horses. Six horses received medetomidine hydrochloride 7μg/kg IV alone (MED) or with vatinoxan hydrochloride 140μg/kg IV (MED+V). Anesthesia was induced with midazolam and ketamine and maintained with isoflurane and medetomidine CRI for 60min. Heart rate, ...
Comparative Anti-inflammatory Effects of Insulin and Flunixin on Acute-Phase Responses and Cardiovascular Biomarkers During Inflammatory Phase in Miniature Donkeys. The objective of this study was to comparatively evaluate the anti-inflammatory effects of intravenous administration of insulin (in different doses) and flunixin on physiological variables, acute-phase responses, and cardiovascular biomarkers during inflammatory phase which was induced by Escherichia coli lipopolysaccharide (LPS) serotype O55:B5 in miniature donkeys. A total of twenty-four clinically healthy male adult miniature donkeys aged 5 ± 1 year and weighing 120 ± 10 kg were studied. The animals were assigned randomly to four experimental groups (three treatment and one positive co...
Near-Newtonian Blood Behavior – Is It Good to Be a Camel? From a certain level of exercise-intensity onward, hematocrit increases in horses, which brings more oxygen carriers into the bloodstream. Camels, however, when used in competitive racing could be even in need of iron supplementation and blood transfusions due to a severe reduction of their available hematocrit compared to their resting hematocrit. Since the extrinsic and intrinsic mechanical properties of camel erythrocytes (RBC) are so different compared to RBCs of other mammals, the question arises whether this observation might be a response to endurance exercise aiming at keeping the RBC ...
The Spatiotemporal Characteristics of 0-24-Goal Polo. Global positioning systems (GPS) have recently been shown to reliably quantify the spatiotemporal characteristics of Polo, with the physiological demands of Polo play at low- and high-goal levels also investigated. This study aims to describe the spatiotemporal demands of Polo across 0-24 goal levels. A player-worn GPS unit was used to quantify distance, speed and high-intensity activities performed. Data were divided into chukkas and five equine-based speed zones, grouped per cumulative player handicap and assessed using standardized mean differences. Average distance and speed per chukka inc...
Echocardiographic Evaluation of Myocardial Function in Standardbreds During the First Year of Race Training. Several studies have shown the effect of training on myocardial deformation parameters in human athletes. The aim of this prospective, longitudinal study was echocardiographic evaluation of myocardial velocities and deformation in horses during the first year of training. Twelve Standardbred yearlings were examined using tissue Doppler imaging (TDI) and two-dimensional speckle tracking (2D-ST) during the first year of race training (short axis of left and right ventricle). The first examination was performed before the beginning of training (n = 12). At the last time point, horses were fully ...
Experimentally Induced Open Pneumothorax in Horses. The objective of this study was to evaluate clinical and cardiovascular parameters and pleural and intra-abdominal pressures of horses after experimentally induced unilateral open pneumothorax. Prospective, experimental study-animals: seven healthy adult horses, 4 females and 3 males. Left hemithorax thoracotomy was carried out to create an open pneumothorax for 60 minutes. Pleural pressure (P) was directly obtained at the midpoint of the left eighth intercostal space before thoracotomy. Esophageal pressure (P), arterial blood gas analysis, left ventricular function, and ultrasonographic asses...
Heart rate variability parameters as markers of the adaptation to a sealed environment (a hypoxic normobaric chamber) in the horse. Simulated hypoxic normobaric devices have been used in human beings in order to enhance endurance capacity. These devices are sealed chambers where the athletes are supposed to stay for at least 6-8 hr daily. The current research assesses the changes in time-domain, spectral and non-geometrical heart rate variability (HRV) parameters in 6 horses subjected to progressive duration periods inside of a hermetically sealed chamber. It was pursued, firstly to evaluate the intensity of the stress experienced by the animals and secondly to elucidate whether the horses might require an acclimation per...
Donkey pericardium compares favorably with commercial xenopericardia used in the manufacture of transcatheter heart valves. Transcatheter aortic valve implantation (TAVI) has gained considerable acceptance in the past decade due to its lower risks than conventional open-heart surgery. However, the deformation and delamination of the leaflets during the crimping procedure have raised questions about the durability and long-term serviceability of the pericardium tissue from which the leaflets are made. The collagen architecture, wall thickness and mechanical properties of donkey pericardium were investigated to assess its suitability as an alternative material for the manufacture of heart valves. Coupons sampled from...
A retrospective comparison of induction with thiopental/guaifenesin and propofol/ketamine in Thoroughbred racehorses anesthetized with sevoflurane and medetomidine during arthroscopic surgery. This study compares clinical characteristics between induction with thiopental/guaifenesin and propofol/ketamine in Thoroughbred racehorses anesthetized with sevoflurane and medetomidine. Clinical records of 214 horses that underwent arthroscopic surgery between 2015 and 2016 were retrospectively retrieved. Horses were premedicated with medetomidine and midazolam to sedate at the adequate level for smooth induction, and then induced with either thiopental (4.0 mg/kg) and guaifenesin (100 mg/kg) in Group TG (n=91) or propofol (1.0 mg/kg) and ketamine (1.0 mg/kg) in Group PK (n=123). Anesthesia ...
Percutaneous transcatheter closure of an aorto-cardiac fistula in a six-year-old Warmblood mare with atrial fibrillation. This report describes a rare case of an aorto-cardiac fistula in a six-year-old French Warmblood mare presented with atrial fibrillation, decreased performance, ventral oedema, bounding arterial pulsation and pathological jugular venous pulse. A 2.7-cm-diameter fistula connected the right aortic sinus of Valsalva to the right atrium. Atrial fibrillation was likely due to volume overload of the right heart due to left-to-right shunting. The horse was treated by percutaneous transcatheter closure of the fistula delivered under general anaesthesia using a transarterial approach. The operation was...
Indirect Blood Pressure Measurement in Horses: Is There an Influence of Age, Sex, Breed, Bodyweight, and Cardiac Diseases on Pressure Values? Only few data regarding normal resting blood pressure in horses and the influence of cardiac diseases on arterial blood pressure are available in literature. The purpose of the present study was to investigate the possible influence of age, sex, breed, bodyweight, and cardiac diseases and their severity on blood pressure values measured in horses with cardiac disease and in a control group. For this case-control study, indirect blood pressure measurement was performed in 60 horses with different types of cardiac disease and in 23 healthy horses (control group), by means of an ultrasonic blood-...
Plasma concentrations at two dexmedetomidine constant rate infusions in isoflurane anaesthetized horses: a clinical study. To determine dexmedetomidine plasma concentrations at two infusion rates in isoflurane anaesthetized horses and compare cardiovascular effects and anaesthetic recovery between treatments. Methods: Prospective, randomized, masked clinical study. Methods: Healthy, adult, client-owned, non-food producing horses presented for castration. Methods: Premedication consisted of acepromazine, romifidine and morphine, and anaesthesia was induced with ketamine and midazolam. The horses were randomized to receive dexmedetomidine 0.5 μg kg hour (treatment DL, n = 7) or 1.75 μg kg hour (treatment DH, n =...
Utility and accuracy of a smartphone-based electrocardiogram device as compared to a standard base-apex electrocardiogram in the horse. Evaluate accuracy and utility of a smartphone-based ECG device compared to a standard base-apex lead ECG in horses. Methods: ECGs were acquired prospectively from 28 client-owned horses at 2 equine referral hospitals. Twenty-five pairs of 30-s ECG recordings were acquired simultaneously from 23 horses with a smartphone ECG device (a bi-polar single lead recorder coupled to a smartphone with an ECG application) and with a standard base-apex lead ECG; 2 horses provided two pairs of simultaneously acquired ECGs. In one horse, the ECGs pairs were recorded immediately sequentially. An additional 7 ...
The effect of insulin infusion on heart rate and systemic blood pressure in horses with equine metabolic syndrome. There is little evidence that horses with equine metabolic syndrome (EMS) have higher resting blood pressures than horses with normal insulin sensitivity. However, there are indications that EMS horses have an altered dynamic response to the cardiovascular effects of insulin. Objective: To examine heart rate and the systemic blood pressure response in EMS and control horses during insulin infusion. Methods: Cross-sectional study. Methods: Horses were examined with an oral sugar test (OST) and a euglycaemic hyperinsulinaemic clamp (EHC). Based on the results from the OST, the horses were classi...
Diagnostic value of noninvasive pulse pressure measurements in Warmblood horses with aortic regurgitation. Noninvasive blood pressures (NIBP) and pulse pressures (PP) have not been published in horses with aortic and mitral regurgitation (AR or MR). Objective: To investigate NIBP and PP in healthy Warmblood horses and horses with AR and MR and propose PP cutoffs to identify and stage AR severity. Methods: Seventy-three Warmblood horses (healthy, 10; AR, 31; MR, 32). Methods: Retrospective study. All horses had NIBP and an echocardiogram recorded. Cases were categorized based on severity of regurgitation. Pulse pressures were compared among healthy, MR, and AR groups and among AR severity groups. Cu...
Cardiac Pathology and Genomics of Sudden Death in Racehorses From New York and Maryland Racetracks. Postmortem evaluation of racehorses has focused primarily on musculoskeletal injuries; however, horses also die suddenly on the track (sudden death [SD]). Although cardiac conditions are frequently suspected as a cause of death, SD racehorses are often autopsy negative; however, previous studies have been limited due to inconsistent or insufficient cardiac sampling and lack of controls. SD in New York (NY) and Maryland (MD) racehorses was evaluated in an observational case vs control study comparing clinical information, postmortem evaluation including cardiac dissection, and cardiac conductio...
Effects of vatinoxan on cardiorespiratory function and gastrointestinal motility during constant-rate medetomidine infusion in standing horses. Medetomidine suppresses cardiovascular function and reduces gastrointestinal motility in horses mainly through peripheral α -adrenoceptors. Vatinoxan, a peripheral α -antagonist, has been shown experimentally to alleviate the adverse effects of some α -agonists in horses. However, vatinoxan has not been investigated during constant-rate infusion (CRI) of medetomidine in standing horses. Objective: To evaluate effects of vatinoxan on cardiovascular function, gastrointestinal motility and on sedation level during CRI of medetomidine. Methods: Experimental, randomised, blinded, cross-over stud...
Cardiac Therapeutics in Horses. Many cardiac therapeutics lack significant evidence of benefit in the horse, and in many cases their use is based on extrapolation of evidence from other species. In recent years there has been a push to develop a better understanding of both the pharmacodynamics and pharmacokinetics of these drugs. Recent data have described the use of antiarrhythmic agents including sotalol, flecainide, and amiodarone. Data about the use of ACE inhibitors in the management of congestive heart failure are encouraging and support their use in certain cases, wheras evidence for other medicines, such as pimobend...
Equine Electrocardiography. Analyzing electrocardiographic (ECG) recordings, making a diagnosis and assessment of any arrhythmias present, is an important part of the workup of many equine cases. Accurate analysis requires a good-quality recording, free of as many artifacts as possible, with clear P-QRS-T complex morphology. For sustained arrhythmias, short-term recordings are sufficient to make the appropriate diagnosis before instigating treatment. Longer-term recordings are essential for arrhythmias that are paroxysmal, intermittent, or occurring infrequently, while exercising ECGs are required for arrhythmias associa...
Cardiovascular Causes of Poor Performance and Exercise Intolerance and Assessment of Safety in the Equine Athlete. Horses have a high prevalence of resting arrhythmias, cardiac murmurs, and valvular regurgitation, and training can increase the prevalence. This makes it challenging for equine veterinarians who are asked to evaluate horses for poor performance to determine the clinical relevance of some findings. In addition, cardiac disease has the potential to cause collapse or sudden death, putting both the horse and rider at risk. Further diagnostics, such as echocardiograms and resting and exercising ECGs can help to sort out the impact of an abnormality found on resting physical examination. However un...
Cardiac Arrhythmias in Horses. Arrhythmias are common in horses. Sinus arrhythmia and first- and second-degree atrioventricular block are frequently found physiologic arrhythmias, but should immediately disappear after stress or exercise. Atrial premature depolarizations are usually not associated with poor performance, but are a potential trigger for atrial fibrillation. Atrial fibrillation results in an abnormal ventricular response during exercise and poses a risk for collapse in some horses. This arrhythmia can usually be treated by quinidine sulfate or transvenous electrical cardioversion. Ventricular premature depolar...
Assessment of the Cardiovascular System in Horses During Prepurchase and Insurance Examinations. Arrhythmias detected on prepurchase examination should be confirmed with an ECG. Exercising ECG determines if the arrhythmia is overdriven during exercise or is a safety concern. An echocardiogram is needed in all horses with a grade 3/6 or louder mid to late systolic, holosystolic, or pansystolic murmur or any holodiastolic decrescendo murmur to identify the cardiac abnormality and its hemodynamic impact. Most horses with arrhythmias and murmurs have a normal performance career and life expectancy and are insurable. Risks for sudden death and congestive heart failure associated with the commo...
Overview of Equine Cardiac Disease. Equine heart diseases can be categorized with morphologic, etiologic, and physiologic diagnoses and classified anatomically as diseases of the pericardium, myocardium, valves (endocardium), and great vessels. An appreciation of normal and pathologic physiology is a key to understanding diagnosis and therapy of heart disease. Pathophysiologic diagnoses include arrhythmias, congestive heart failure, and pulmonary hypertension. Heart rhythm disturbances can occur in isolation or with structural disease. Heart failure stems from arterial filling owing to insufficient cardiac output. Pulmonary hype...
Cardiac Monitoring in Horses. Monitoring variables of cardiac performance in horses is challenging owing to patient size, temperament, and anatomic peculiarities. Blood pressure is a major determinant of afterload, but it is not a reliable surrogate of cardiac performance and tissue perfusion. Cardiac output, together with arterial and venous oxygen content, provides insight as to the adequacy of delivery of blood and oxygen to the body as a whole and can be used to gauge the fluid responsiveness and cardiovascular status of the patient. Measurement of intracardiac pressures serves to assess cardiac filling pressures, myoc...
Examination of Horses with Cardiac Disease. Despite advances, increased convenience, and availability of echocardiography and other diagnostic techniques in equine cardiology, a comprehensive history and clinical examination still forms the essential first step in any cardiac evaluation. This article summarizes the approach to the cardiac examination at rest, highlighting key areas for the clinician to assess, and stressing the importance of context for assessing the significance of any abnormalities detected. Ancillary techniques, such as blood pressure measurement and the laboratory assessment of cardiac disease in the horse, are also...
Pericardial Disease, Myocardial Disease, and Great Vessel Abnormalities in Horses. Pericardial, myocardial, and great vessel diseases are relatively rare in horses. The clinical signs are often nonspecific and vague, or related to the underlying cause. Physical examination usually reveals tachycardia, fever, venous distension or jugular pulsation, a weak or bounding arterial pulse, ventral edema, and abnormal cardiac auscultation such as arrhythmia, murmur, or muffled heart sounds. The prognosis depends on the underlying cause and the disease progression, and ranges from full recovery to poor prognosis for survival. This article focuses on the etiology, diagnosis, prognosis,...
Cardiovascular Response to Exercise and Training, Exercise Testing in Horses. The physiology of exercise and training is fascinating, and hundreds of interesting studies have given insight into its mechanisms. Exercise testing is a useful clinical tool that can help veterinarians assess poor performance, fitness, and performance potential and prevent injuries. The clinically applicable aspects of cardiovascular adaptions to training and exercise testing are highlighted in this review. Different exercise tests should be used to evaluate horses performing in different disciplines and levels. Exercise tests that simultaneously assess several body systems can be beneficial ...
Equine Acquired Valvular Disease. Degenerative myxomatous disease is common and is associated with aging. Poor prognostic indicators for equine aortic regurgitation specifically include ventricular ectopy, increased pulse pressure, and hyperkinetic pulses. Valvular prolapse is a functional abnormality diagnosed echocardiographically, about which knowledge is limited. A better understanding of its role in valvular regurgitation is needed. Infective endocarditis presents with fever and other systemic signs accompanying valvular regurgitation. The prognosis is poor, warranting aggressive therapy. Other forms of valvular disease o...
Equine Echocardiography. This article provides an overview on the principles of transthoracic echocardiography in horses. Indications for echocardiography, equipment, and technical considerations are discussed and a systematic approach for a complete echocardiographic examination in horses is described. Methods for assessment of chamber dimensions, allometric scaling of measurements, assessment of systolic and diastolic ventricular function, assessment of atrial function, hemodynamic assessment, and evaluation of valvular regurgitation are explained, focusing on traditional 2-dimensional (2D), motion-mode, and Doppler...
Equine Congenital Heart Disease. Congenital heart disease (CHD) represents a small proportion of horses undergoing clinical evaluation; however, both simple and complex defects occur during cardiac development leading to many unique malformations. This article reviews cardiac development and the fetal circulation, describes the morphologic method and the sequential segmental approach to CHD analysis, presents a summary of CHD in horses, and offers an overview of lesions that should be considered during evaluation of horses suspected to have CHD. For many forms of equine CHD, therapies are limited because cardiac interventions...